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The problem is we cannot get the HMO to give us a
skilled rate. After our begging and pleading they are taking two to three
weeks before giving us a response that they are denying our request for skilled
rate.
We had a fresh hip fracture requesting skilled rate
and they denied. That is why I need to know what rules are HMo's suppose
to follow in regards to who they give skill rates to and who they do
not.
Dawn Sheppard, RN, CRNAC
I have found that adhering to medicare rules for skilling and documentation is satisfactory. We call weekly with report to the hmo, who then either recert for another time period, usually a week, or let us know that we are approaching or have approached the time where they will not pay for the services. GJ Ferlick, RNAC Ambler Rest Center Ambler, PA |
